在冠状动脉支架术后支架内再狭窄中应用运动平板试验的评估价值

The Value of Treadmill Testing to Evaluate In-stent Restenosis on the Patients after PCI

目的了解运动平板试验在评估冠状动脉支架术后支架内再狭窄的价值。方法81例PCI术后患者均在术后进行了运动平板试验及冠状动脉造影检查,以冠状动脉造影检查结果作为金指标,分析计算运动平板试验对于诊断支架内再狭窄的敏感性、特异性、阳性预测率、阴性预测率,及Kappa值。结果运动平板试验诊断支架内再狭窄的敏感度为52.9%,特异度为88.4%,阳性预测率为47.4%,阴性预测率为87.1%,在诊断单支病变的支架内再狭窄的敏感度66.7%,特异度96.2%,阳性预测率80%,阴性预测率92.6%,Kappa值为0.671。结论运动平板试验对于评估支架内再狭窄有一定的临床意义,尤其是在单支病变PCI术后的患者中,运动平板试验诊断支架内再狭窄与冠状动脉造影检查有较高的一致性,对于临床诊治有指导作用。

Objective To assess the value of treadmill testing to evaluate in-stent restenosis on patients after PCI（pereutaneous transluminal coronary intervention）. Methods Eighty-one patients who undergone successful PCI were performed treadmill testing and CAG（coronary artery angiography）.The result of CAG as the ＂gold standard＂, accounted the sensitivity, specificity, the rate of positive prognosticate, the rate of negative prognosticate and data Kappa which the treadmill testing to detect in-stent restenosis. Result The sensitivity, specificity, rate of positive prognosticate and rate of negative prognosticate was 52.9%, 88.4%, 47%, 87.1% respectively. Especially in the single-vessel group, the result was 66.7%, 96%, 80%, 92.6% respectively and the data Kappa was 0.671. Conclusion In the patients who underwent PCI, the treadmill testing could be useful to detect the in-stent restenosis. In single-vessel group, the result of the treadmill testing was consilient compare the CAG, The treadmill testing can be used in clinic to guide the patients＇ treatment after PCI.